Acceptance of Treatment of Depression

As more people find themselves suffering from depression, more individuals are not reporting their symptoms to their doctors. The reason for this is based on their fear of the treatment their doctor may recommend.

The Annals of Family Medicine recently published an article titled Suffering in Silence: Reasons for Not Disclosing Depression in Primary Care. In this study, they found that out of 1054 adults studied, 43% of them were reluctant to disclose symptoms of depression to their physicians. “Concern that the physician would prescribe antidepressants was the leading reason for nondisclosure of depression, far surpassing concerns about referral for psychotherapy. These findings suggest that patients lack confidence in their ability to negotiate an acceptable plan of care that reflects their treatment preferences.”

In the Annals study, the authors found that over 87% of respondents felt that their primary care physician was the appropriate source for depression care. In the article Which Doctor is Best for Treating Depression, it was noted, “Studies show that 74% of people seeking help for depression will first go to their primary care physician. Of these cases, as many as 50% are misdiagnosed. Even of the cases that are correctly diagnosed, 80% are given too little medication for too short a time.”

In Medscape Today, it was noted that psychiatrists sometimes prefer for family practitioners to treat mild-to-moderate depression as long as they do the proper analysis, “Screening is best accomplished with the brief 9-item Patient Health Questionnaire (PHQ-9). Patients are asked how often they experience certain problems, such as lack of interest in activities, trouble sleeping, loss of appetite, inability to concentrate, and thoughts about death. Easy to use and score, this tool allows you to determine the severity of the illness.”

For those who have had side effects to prior medications, the thought of trying something that may make them feel worse may be a real concern. In The Journal of Internal Medicine article, Older Patients’ Aversion to Antidepressants, the authors found, “Four themes characterized resistance to antidepressants: (1) fear of dependence; (2) resistance to viewing depressive symptoms as a medical illness; (3) concern that antidepressants will prevent natural sadness; (4) prior negative experiences with medications for depression.”

It may be easier for physicians to prescribe an antidepressant than to spend time researching other possible causes of their patients’ symptoms. Primary care physicians are prescribing more antidepressants than ever. “Nearly three-quarters of all prescriptions for anti-depressants are written without a specific diagnosis. This has medical experts worried that anti-depressants are being prescribed too often to patients who may not need them. According to IMS Health, an estimated total of 254 million prescriptions were written for anti-depressants last year alone, up from 231 million in 2006. Each year, Americans spend $10 billion on anti-depressants. Additionally, seven percent of all visits to a primary care doctor end up with a prescription being written for anti-depressants.”

While some may say that depression is on the rise, others argue that people are looking for a panacea or are requesting medications due to direct to consumer advertisements by the drug manufacturers.